Provider Demographics
NPI:1013542059
Name:BURGOS, MEGHAN DOLORES (BSN, RN, CCRN)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:DOLORES
Last Name:BURGOS
Suffix:
Gender:F
Credentials:BSN, RN, CCRN
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:DOLORES
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN, CCRN
Mailing Address - Street 1:303 HERMITS TRL
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-3623
Mailing Address - Country:US
Mailing Address - Phone:786-271-6481
Mailing Address - Fax:
Practice Address - Street 1:425 S HUNT CLUB BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4947
Practice Address - Country:US
Practice Address - Phone:407-786-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015704363LP0200X
FLRN9410676163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics